Researcher of the Medicine, Dow University of Health Sciences (DUHS), Karachi, PAKISTAN – Ujala Zubair, has developed an index that identifies the risk for Parkinson disease (PD) based on the presence and degree of a pre “non-motor” symptom of runny nose. That is, identifying people with PD even before they have their first symptom of tremor, bladder/bowel inconsistency, slowness, stiffness, sleep or smell disorders or anything else like that.

A systematic review has been undertaken to determine the nature & extent of non-motor symptoms in drug-naive Parkinson’s patients. The findings are published in the open access journal distributed under the terms of the Creative Commons Attribution License CC-BY 3.0.

Rhinorrhea is a medical term for runny nose, meaning the “fluid flowing from the nose” and can literally refer to anything flowing from it. To find out if runny nose was more common in Parkinson’s disease patients, the co-author conducted a study considering the certainty that – if Rhinorrhea is common in PD, it also may be common in older peeps in general, just like arthritis or dementia or constipation.                                                                 This study compared the (1) frequency of rhinorrhea between PD and normal controls (NC) and (2) investigated the relationship between rhinorrhea and clinical (gustation & olfaction, motor and autonomic) characteristics, and (3) the magnitude of nigrostriatal dopaminergic denervation in PD.

Understanding the Non-motor symptoms of Parkinson’s disease that commonly includes erectile dysfunction, low BP, anxiety, fatigue, hallucinations, and memory issues, the authors found that these are scarcely used for the diagnosis of PD at an early stage

Therefore, applying runny nose as a “pre-motor” symptom of Parkinson’s disease, a 70-year-old male case reported to OPD with watery discharge on thought or site of food. Indicative therapy was suggested on many inspections for the cause but did not materialize beneficially. Almost after 2 years, the patient developed fine tremors only in fingers and hands which were clear indication of Parkinson’s disease. Upon further evaluation reported an altered sense of smell which went neglected by the patient and the patient was diagnosed with Parkinson’s disease. Initiation of Dopamine-based treatment resulted in improvement of rhinorrhea as well as motor features.

Ujala Zubair, the corresponding author said: there are some traces discovered so far that suggest that Parkinson’s disease might develop in the presence of Rhinorrhea.

Reduced smell abilities which is a much familiar problem in PD, is common in elderly people, and often occurs early in Alzheimer’s disease, sinus conditions, and years before any marks of Parkinson’s disease appears. Another one involves REM sleep behavior which is a rare type of sleep disorder and is prevalent in Parkinson’s disease but uncommon outside of PD, and develops years before the first movement symptom of PD emerges.

On these grounds, the author projects the presence of Rhinorrhea as another useful inkling of developing PD and that People with PD were more plausible to have a runny nose. Rhinorrhea turned out to be twice more common in people with Parkinson’s Disease than without Parkinson’s of the same age, and again, the outcomes of research were statistically significant.

The results also confirm the hypothesis that (1) rhinorrhea unrelated to allergies, respiratory infections or sinus would be more prevalent in PD than in healthy controls, (2) rhinorrhea would be inapplicable olfaction, motor function, or nigrostriatal denervation in Parkinson’s patients, and (3) rhinorrhea would be associated to other autonomic issues in PD.

The authors caution that the actual risk index of Rhinorrhea in developing Parkinson’s disease needs to be validated in future longitudinal studies. However, the observations made in this study suggest some motor tests that could eventually be helpful in early screening for Parkinson’s. Further imaging such as DAT can be carried to corroborate final diagnosis. Rare presentations are advised to not be overlooked while assessing high risk individuals.

According to the author, if finally we find a therapy that will decelerate the PD progression, then if we can identify people who have PD before they have motion deficits, maybe we will prevent them, or at least thwart them.


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